Alexander Steven Gilmore, D.C.

Individual provider Active NPI Nutrition Chiropractor · Cedaredge, CO

NPI 1902011489 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902011489
Entity type
Individual (NPI type 1)
Primary specialty
Nutrition Chiropractor 111NN1001X
License
5432 (CO)
Practice address
105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone
(970) 856-3545
Fax
(970) 434-8501
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Logan College of Chiropractic, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone (970) 856-3545

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120220000946 CO Practitioner - Chiropractic 6103715594 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Total Family Wellness Inc. Nutrition Current
since Feb 1, 2003
Accepting new patients

Locations

105 SE Greenwood Ave
Cedaredge, CO 81413
Phone (970) 856-3545

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 5432 CO Yes

Addresses

Primary practice location

105 SE Greenwood Ave
Cedaredge, CO 81413-4003

Mailing address

105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone (970) 856-3545

Other providers in Cedaredge, CO

All providers in Cedaredge, CO · Nutrition Chiropractor in Colorado

Sources for this page

Verify at the official NPI Registry.